- Evolent (Providence, RI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to… more
- Evolent (Providence, RI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Baylor Scott & White Health (Providence, RI)
- …**SPECIALTY/DEPARTMENT:** Care Management: Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** Full-time days, Monday-Friday, 8:00 ... vary based on position type and/or level **Job Summary** A Registered Nurse in Nursing Professional Development Generalist role uses expertise to enhance healthcare… more
- Brockton Hospital (Brockton, MA)
- …agencies, to coordinate activities involved in medical record review, denials, appeals and reconsideration hearings. Works closely with the physician advisor to ... EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is reasonable to… more